Elizabeth Harris

• UNSW Sydney

Introduction Community health workers (CHWs) help bridge the cultural gap between health services and the communities they serve. CHWs work with physicians, nurses and social workers, but little is known about their collaboration with pharmacists. This scoping review aims to describe the interprofessional collaboration between CHWs and pharmacists,...

Background Patients from culturally and linguistically diverse (CALD) backgrounds often face difficulties in accessing health and social care services. This study explored the feasibility and acceptability of involving community health workers (CHWs) as bilingual community navigators (BCNs) in general practice setting, to help patients from CALD ba...

This research aimed to explore the needs, potential roles and implementation of Bilingual Community Navigators (BCNs) in providing navigation support for patients in general practice settings in Australia. A total of 19 participants (general practitioners, practice managers, practice nurses and receptionists) from five general practices in Sydney w...

‘City Deals’ are new governance instruments for urban development. Vast evidence exists on the relationship between urban factors and health equity, but little research applies a health equity lens to urban policy-making. This paper does precisely that for the Western Sydney City Deal (WSCD) in Australia. We conducted a critical discourse analysis...

Background This review was carried out to synthesize the evidence of the effectiveness of community health worker (CHW) navigation in primary care chronic disease management. Methods We searched the English language literature between January 1990 and March 2020 in Medline, Embase, Emcare, PubMed, Psych Info, CINAHL, Scopus, and Medline Epub ahead...

Objectives General practitioner (GP) follow-up after a hospital admission is an important indicator of integrated care. We examined the characteristics of patients who saw a GP within 2 weeks of hospital discharge in the Central and Eastern Sydney (CES) region, Australia, and the relationship between GP follow-up and subsequent hospitalisation.Meth...

The Rohingya community living in the City of Canterbury-Bankstown in Sydney have been identified as a priority population with complex health needs. As part of ongoing work, AU$10000 was provided to the community to address important, self-determined, health priorities through the Can Get Health in Canterbury program. Program staff worked with comm...

Background: Recently arrived culturally and linguistically diverse migrant mothers in Western Industrialised Nations are less likely to access health care and are more likely to report negative healthcare experiences than more established migrant or non-migrant populations. This is particularly an issue in Australia where nearly half of all Austra...

Objectives To review effective models of community health worker (CHW) involvement in preventive care for disadvantaged culturally and linguistically diverse (CALD) patients in primary healthcare (PHC) that may be applicable to the Australian context. Design Systematic scoping review. Data sources The studies were gathered through searching Medli...

Background: The number of people living with chronic health conditions is increasing in Australia. The Chronic Disease Management program was introduced to Medicare Benefits Schedule (MBS) to provide a more structured approach to managing patients with chronic conditions and complex care needs. The program supports General Practitioners (GP)s clai...

Aim To describe the characteristics of people in Central and Eastern Sydney (CES), NSW, who had a General Practice Management Plan (GPMP) and claimed for at least one private allied health service item; and to examine if allied health service use results in less hospitalisations over a five-year period. Background The number of people living with...

People from diverse cultural and linguistic backgrounds are more likely to have low health literacy and less appropriate access to health services than other Australians. Interventions to improve health literacy have demonstrated moderate improvements in health service use. Most of these interventions focus on simplifying communication as opposed t...

Introduction: It is anticipated that by 2030 the number of older people and people living with long term conditions will have significantly increased. At the same time, it is expected that there will be a shift to providing more health care in the community. Browning et al [1] using a prospective 16-year longitudinal study of 1000 older Australians...

Can Get Health in Canterbury (CGHiC) is a locality-based project that aims to improve health and reduce inequities for marginalised culturally and linguistically diverse groups by increasing access to comprehensive primary health care services and addressing the underlying social determinants of health in a socio-economically disadvantaged Local Go...

Introduction: In Australia there has been a sharp increase in the proportion of older people who live alone. Living alone increases the risk of being socially isolated or experiencing loneliness. Older people who are lonely have an increased risk of dying sooner and are more likely to experience a decline in their mobility [1]. Understanding if and...

Introduction: The Healthy Homes and Neighbourhoods (HHAN) integrated care program seeks to enhance vulnerable family access to, and engagement with, health and social services. This is achieved through a care-coordination model and other integrated care activities targeted towards capacity building at the professional and organisational level. The...

The number of older people living with chronic health conditions is increasing in Australia. The Chronic Disease Management (CDM) items program was introduced to the Medicare Benefits Schedule (MBS) to encourage a more structured approach to managing patients with chronic conditions. Initial uptake was slow and recent research has suggested that up...

Objective The aim of this study was to identify whether the Hospital in the Home (HITH) program was taken up equitably by eligible patients in relation to their age, sex, country of birth, place of residence and primary diagnosis.Methods This study presents results of a descriptive analysis of the administrative records of 3552 people with specific...

Background: In Australia there is commitment to developing interventions that will 'Close the Gap' between the health and welfare of Indigenous and non-Indigenous Australians and recognition that early childhood interventions offer the greatest potential for long term change. Nurse led sustained home visiting programs are considered an effective w...

There is strong, and growing, evidence documenting health inequities across the world. However, most governments do not prioritize policies to encourage action on the social determinants of health and health equity. Furthermore, despite evidence concerning the benefits of joined-up, intersectoral policy to promote health and health equity, it is ra...

Mobilising cross-sectoral action is helpful in addressing the range of social determinants that contribute to health inequities. The South Australian Health in All Policies (SA HiAP) approach was implemented from 2007 to stimulate cross-sector policy activity to address the social determinants of health to improve population wellbeing and reduce he...

Background The practices of transnational corporations affect population health through production methods, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. Our pilot research used McDonald’s Australia to...

Data on patient access to, and use of, primary and secondary care services are a potential tool for population health and health service planning, and for researchers. The Sax Institute's 45 and Up Study was established to support research about healthy ageing. This paper considers how data from the 45 and Up Study could be useful to Local Health D...

Health systems have long been criticised for focussing on curing rather than preventing disease. This paper examines to what extent the Adelaide Thinkers in Residence (ATiR) scheme contributed to the change in norms whereby promoting well-being and a strategy to achieve this - Health in All Policies (HiAP) - was adopted by the South Australian (SA)...

Background: While many guidelines explain how to conduct Health Impact Assessments (HIAs), less is known about the factors that determine the extent to which HIAs affect health considerations in the decision making process. We investigated which factors are associated with increased or reduced effectiveness of HIAs in changing decisions and in the...

We have been asked to assist in the creation of a paper for inclusion into an overview of existing global knowledge on the social determinants of Indigenous health. This overview will become a part of an international symposium sponsored by the World Health Organization’s Commission on Social Determinants of Health (CSDH). This symposium is to be h...

Health in All Policies (HiAP) is a policy development approach that facilitates intersectoral responses to addressing the social determinants of health and health equity whilst, at the same time, contributing to policy priorities across the various sectors of government. Given that different models of HiAP have been implemented in at least 16 count...

Rationale: The Australian Government’s Closing the Gap Initiative encourages general practitioners to actively work towards the chronic disease management of their Aboriginal patients. Practitioners must know the Indigenous status of their patients in order to provide appropriately targeted care, yet in urban areas only around 35% of Aboriginal and...

Background Policy decisions made within all sectors have the potential to influence population health and equity. Recognition of this provides impetus for the health sector to engage with other sectors to facilitate the development of policies that recognise, and aim to improve, population outcomes. This paper compares the approaches implemented to...

This article describes some of the crucial theoretical, methodological and practical issues that need to be considered when evaluating Health in All Policies (HiAP) initiatives. The approaches that have been applied to evaluate HiAP in South Australia are drawn upon as case studies, and early findings from this evaluative research are provided. The...

Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust...

Objective: To describe the use and reporting of Health Impact Assessment (HIA) in Australia and New Zealand between 2005 and 2009. Methods: We identified 115 HIAs undertaken in Australia and New Zealand between 2005 and 2009. We reviewed 55 HIAs meeting the study's inclusion criteria to identify characteristics and appraise the quality of the re...

The use of health impact assessment (HIA) has expanded rapidly and there are increasing demands for it to demonstrate its effectiveness. This paper presents a conceptual framework for evaluating HIA and describes its development through (i) a review of the literature, (ii) a review of work undertaken as part of a major HIA capacity building project...

The aims of this paper are to describe the growth of urban Australian Aboriginal infants from birth to 24 months of age and to identify the proportion of these infants experiencing rapid weight gain (RWG) and overweight/obesity. The Gudaga Study is a longitudinal birth cohort of 159 Australian Aboriginal children born on the urban fringe of Sydney....

For almost 20 years public health leaders and organizations in Australia have supported the development of HIA. Some of the world’s first HIA guidance was developed in Australia. Despite this it has been difficult to locate a ‘home’ for HIA in Australian policy and planning processes. While EIA has long been mandated in legislation at state and fed...

To report a programme theory for pre-natal home visiting by nurses in the context of a sustained nurse home visiting programme by exploring pre- and postnatal outcomes and characteristics of the intervention that may have contributed to the outcomes. Studies have shown sustained nurse home visiting commencing pre-natally to be effective. Few studie...

The very long-term unemployed (i.e. those unemployed for more than 2 years) face serious mental health problems and social difficulties in regaining employment. To assess the effectiveness of a pilot vocationally oriented cognitive behaviour therapy (CBT) programme on mental health and vocational outcomes among a group of very long-term unemployed....

This paper reflects on the challenges and strategies used to conduct a sustained nurse home visiting randomised trial within the universal child and family health service system in Australia. The Maternal Early Childhood Sustained Home-visiting (MECSH) programme is a complex multilevel intervention acting in parallel at the individual and organisat...

People living in socioeconomically disadvantaged communities have a high burden of disease but often receive 'inverse care'. We explored a model of general practitioner and community nurse co-location in a disadvantaged community in south-west Sydney, Australia. Co-location resulted in increased referrals from doctors to the community nurse, includ...

The Gudaga Study is a prospective, longitudinal birth cohort study of Australian urban Aboriginal children. Mothers of Aboriginal infants were recruited using a survey of all mothers admitted to the maternity ward of an outer urban hospital in Sydney. These data established initiation rates among Gudaga infants and those of non-Aboriginal infants b...

There is currently considerable diversity in health impact assessment (HIA) practice internationally. Historically this diversity has been described as simple dichotomies, for example the differences between HIAs of projects and policies. However these distinctions have failed to adequately describe the differences that can be observed between diff...

This paper aims to describe delivery and birth outcomes of Aboriginal infants and their mothers in an urban setting on the east coast of Australia. The paper uses a causal pathway approach to consider the role of risk and protective factors for low birthweight. All mothers who delivered at Campbelltown Hospital between October 2005 and May 2007 wer...

To explore the changing nature of Australia's potential workforce, and comment on the limitations of existing fragmented infrastructure to address the health needs of all potential workers. This paper analyses the changing nature of work in Australia and the challenges this presents to existing health infrastructure. This paper argues that there ar...

To investigate the impact of a long-term nurse home visiting programme, embedded within a universal child health system, on the health, development and well-being of the child, mother and family. Randomised controlled trial. 208 (111 intervention, 97 comparison) eligible at-risk mothers living in a socioeconomically disadvantaged area in Sydney, bo...

ABSTRACT: June 2010 marked the 10th Anniversary of the foundation meeting of the International Society for Equity in Health (ISEqH). he formation of the Society was a bold statement, with ambitions to be a global body "to promote equity in health and health services internationally through education, research, publication, communication and charita...

Equity focused health impact assessments (EFHIAs), or health equity impact assessments, are being increasingly promoted internationally as a mechanism for enhancing the consideration of health equity in the development of policies, programs and projects. Despite this there are relatively few examples of examples of completed EFHIAs available. This...

Rapid Equity Focused Health Impact Assessment of the Australian Better Health Initiative Report

This paper describes the establishment of the Gudaga Study, an Aboriginal birth cohort in south-west Sydney, and our approach to follow-up of participants. The Study describes the health, development, and services use of Aboriginal infants and their mothers. The research team works closely with the local Aboriginal community to implement the resear...

The use of theory in the planning and implementation of health promotion programs will more reliably produce positive outcomes. Following on from the success of the second edition, 'Theory in a Nutshell 3' explores the main theoretical concepts and models in health promotion and explains the significance, practical application and impact of differe...

The number of unemployed patients presenting in general practice will increase over the next 12 months. Unemployed patients are likely to present with physical and psychological problems, including insomnia, depression, anxiety and a worsening of cardiovascular risk factors; family members are also likely to be affected. GPs have an important role...

Increasingly, the role of health research in improving the discrepancies in health outcomes between Indigenous and non-Indigenous populations in developed countries is being recognised. Along with this comes the recognition that health research must be conducted in a manner that is culturally appropriate and ethically sound. Two key documents have...

Within the discipline of health promotion there has been long-standing understanding of the social determinants of health and life expectancy.1-3 There is also long-standing evidence of the unfair, unjust distribution of these resources within and among societies. It has proven difficult to translate this evidence of the need for the fairer distrib...

Unemployment is detrimental to health. The Unemployment and Health Project in South Western Sydney sought to work with labour market programs to improve the health, particularly, mental health, of unemployed people. This paper describes the experiences of the Project. Phase one commenced in 1995 and involved consultation with the majority of Skills...

To explore socio-cultural influences on migrant mother decisions and beliefs regarding co-sleeping as a risk factor for sudden infant death syndrome (SIDS). Semi-structured interviews with five Indian-born women in a socio-economically disadvantaged suburb in the south-west of Sydney were conducted between September and December 2007. Transcripts w...

Internationally the inclusion of health within environmental impact assessment (EIA) has been shown to be limited. While Australian EIA documentation has not been studied empirically to date, deficiencies in practice have been documented. This research developed an audit tool to undertake a qualitative descriptive analysis of 22 Major Project EAs i...

To identify potentially effective strategies to be used in the primary health care (PHC) setting to prevent, detect and manage the health problems of unemployed people. A narrative review of articles on PHC-based interventions for unemployed people that were published during the period January 1985 to February 2009. Seven articles with a focus on i...

Residents of socioeconomically disadvantaged locations are more likely to have poor health than residents of socioeconomically advantaged locations and this has been comprehensively mapped in Australian cities. These inequalities present a challenge for the public health workers based in or responsible for improving the health of people living in d...

Competency identification. The report on mapping of competency identification.

Selected tables. Selected Tables from Locational Disadvantage: Focusing on Place to Improve Health [9].

Home visiting programs comprising intensive and sustained visits by professionals (usually nurses) over the first two years of life show promise in promoting child health and family functioning, and ameliorating disadvantage. Australian evidence of the effectiveness of sustained nurse home visiting in early childhood is limited. This paper describe...

To explore the role of socioeconomic status and Aboriginality on birthweight at an urban hospital. Extraction of data on the demographic characteristics (socioeconomic status, mothers' single-parent status, age and smoking status) and infants' birthweight from a clinical record system. Infants delivered at an outer urban hospital to mothers residin...

To examine prospectively the trajectory of trauma-related psychiatric symptoms and disability amongst asylum seekers over the course of the refugee determination process. To identify the direct impact of the refugee decision on psychiatric symptoms by adjusting for other variables, namely sociodemographic characteristics, past trauma, and ongoing p...

The experience of health impact assessment (HIA) in NSW has shown that it is possible to incorporate considerations of health impacts into decision-making concerning urban planning. In NSW, the Environmental Planning and Assessment Act 1979 is the regulatory framework governing urban planning. This legislative system provides opportunities for HIA...

This study explored the accuracy of identification of Aboriginal infants at an urban hospital. Data on the Aboriginal status of all infants who were delivered at the hospital to mothers who resided in the surrounding Local Government Area during 2002 were extracted from the Obstetrics Data Package (ODP). These data were supplemented with local heal...

Health impact assessment (HIA) can ensure that health is a core element of sustainable urban planning. Based on the experience of the NSW HIA Project, we discuss the current strengths of HIA and challenges facing it as an urban sustainability tool across five areas: the use of evidence; integrating HIA with environmental impact assessments; includi...

'Whole of government' interventions are increasingly being used in disadvantaged communities to improve safety and break the cycle of violence. This paper draws on learning from the evaluation of two whole of government interventions in western Sydney that arose in response to community violence and extensive property damage. Methods for strengthen...

As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the...

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Planned actions by governments can play an important part in addressing the social determinants of health and health inequities. We assess the extent to which Australian health departments are committed to health equity as a core value, and the extent to which strategic directions and policies show evidence of action and achievement in reducing hea...

This paper investigates the use of the 2002/3 NSW Health Survey to provide information on access to and use of quality primary health care (PHC) using type 2 diabetes as a case study. The 2002/3 NSW Health Survey is a telephone survey using Computer Assisted Technology to survey a random sample of NSW residents stratified by area health services. W...

There is strong evidence that comprehensive sustained home visiting programs, commencing antenatally can improve child and maternal outcomes for vulnerable families. Community child and family health nurses, who traditionally engage with families post-birth, are well placed to provide interventions in the antenatal period. There is, however, little...

Currently, primary health care (PHC) is under-represented in health statistics due to the lack of a comprehensive PHC data collection. This research explores the utility of population health surveys to address questions relating to access to and use of PHC, using diabetes as an example. Drawing on published material relating to diabetes management,...

This paper explores the usefulness of the 2001 Australian Bureau of Statistics National Health Survey (2001 NHS) for examining access to and use of quality primary health care (PHC) in Australia, using diabetes as an example. Potential indicators of access to and use of quality diabetes care were investigated (diagnosis, preventive pharmacotherapy,...

A strong primary medical care system is essential to the equity, efficiency and effectiveness of the health system as a whole. General practice in Australia faces significant challenges to its capacity to fulfil its role and function: in its financing, recognition, capacity to provide comprehensive care, and integration with the rest of the health...

This study assessed levels of maternal knowledge of sudden infant death syndrome prevention strategies in a socio-economically disadvantaged, culturally diverse population. Pregnant women (n=233) were asked to name three things they could do to reduce the risk of cot death. Answers were marked in accordance with the US National Institute of Child H...

There are ongoing concerns that asylum seekers who have been tortured and who suffer trauma-related mental disorders are being refused protection by countries in which they seek asylum. The study described here assessed a consecutive sample of recently arrived asylum seekers attending immigration agents in Sydney, Australia, using a series of struc...

This paper sets out to report attitudes of staff on key health service committees towards community participation before and after appointment of community representatives. The paper shows a self-completed questionnaire administered to staff on committees as a baseline measure and 12 months after community representatives had been appointed. The pa...

In recent years, national and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during t...

normative model of a primary health care system developed for this study

In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was fund...